Farmacocinética-farmacodinâmica da vancomicina em pacientes internados em um hospital universitário de Manaus

Abstract

Vancomycin is a key antibiotic in the treatment of Gram-positive infections, caused mainly by Staphylococcus sp and inadequate dosage is associated with therapeutic failure, bacterial resistance and toxicity. According to the literature, therapeutic monitoring of vancomycin is essential to ensure the achievement of clinical results and minimize toxicity. Based on this evidence, this study aimed to evaluate the pharmacokinetic-pharmacodynamic relationship of vancomycin in patients admitted to a university hospital. This was an analytical-observational cross-sectional study that used clinical records and quantified the plasma levels of vancomycin together with the isolation of bacteria from these individuals, from January to October 2020, totaling 50 patients included in the investigation. Most patients were male (60%) and the average age observed was 50.76 ± 19.47 years. The average vancomycin concentrations in the valley period were 40.3mg / L, with a higher occurrence of high levels in patients on polypharmacy and with acute renal failure. Of the 50 patients, 12 obtained a positive culture for Staphylococcus sp and there were reports of two isolates resistant to vancomycin. In addition, approximately 66.6% of patients reached the therapeutic target ASC / MIC> 400mg / h / L. Finally, 40% of the patients died and there was no relationship between the serum level values and this unfavorable outcome. In view of the above, it is recommended to implement protocols for monitoring therapy involving vancomycin in this university hospital.